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All Journal journal of internal medicine E-Jurnal Medika Udayana Media Kesehatan Masyarakat Indonesia Journal of Biomedicine and Translational Research PUBLIKASI PENELITIAN TERAPAN DAN KEBIJAKAN Essential: Essence of Scientific Medical Journal MEDICINUS
I Made Susila Utama
Tropic And Infectious Disease Division, Internal Medicine Dept, Faculty Of Medicine, Universitas Udayana Prof. I.G.N.G.Ngoerah Hospital
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Economics, Econometrics & Finance Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Clinical Features of COVID-19 Patients at Udayana University Hospital During First Three Months of the COVID-19 Pandemic Cokorda Agung Wahyu Purnamasidhi; Ni Made Dewi Dian Sukmawati; Anak Agung Ayu Yuli Gayatri; I Made Susila Utama; I Ketut Agus Somia; Ketut Tuti Parwati Merati; Haruko Akatsu
Media Kesehatan Masyarakat Indonesia Vol. 18 No. 4: DECEMBER 2022
Publisher : Faculty of Public Health, Hasanuddin University, Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30597/mkmi.v18i4.20235

Abstract

COVID-19 exhibits a wide variety of symptoms, ranging from mild, moderate, severe, and critical respiratory dysfunctions up to death. Therefore, this study aimed to examine the demographic, clinical, and laboratory profile of COVID-19 patients admitted to Udayana University Hospital, Bali, during the first three months of the pandemic. Data were collected from the electronic medical records of 236 patients hospitalized from April to June 2020. The samples had a mean age of 40 years old, and they consisted of 58.50% male. Based on the records, the common clinical characteristics included fever (52.5%) and cough (47.5%), followed by less common traits, such as sore throat (18.2%), dyspnea (10.2%), flu (8.9%), and headache (3.8%). Laboratory results during admission showed an average lymphocyte count of 2.16 ± 2.19 × 109 cells/L and a neutrophil- lymphocyte ratio of 3.02 ± 3.41. The majority of patients were private corporation employees (30.51%), followed by migrant workers (21.19%). Furthermore, a fatality rate of 1.69% was recorded in the study hospital. These results were expected to provide epidemiological knowledge of COVID-19 patients, which can help clinicians to anticipate possible outcomes during treatment.
BALB/c Mice as Animal Model in Dengue Infection Research: Role of Endothelial Activation I Made Susila Utama; Tuti Parwati Merati; Made Bakta; Made Jawi
Journal of Biomedicine and Translational Research Vol 9, No 2 (2023): August 2023
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v9i2.17491

Abstract

Introduction. There were various challenges in using experimental animals model for dengue infection studies aside from the fact that dengue infection only naturally affects humans and does not manifest clinical signs as in humans. Various experimental animals have been used in dengue research, but the mouse model is more widely used since it is easier to obtain although sometimes they do not show clinical symptoms but may still measure the immune response. BALB/c mice are immunocompetent mice that have the potential to be used in dengue infection research. Endothelial cell activation plays a role in the pathogenesis of dengue virus infection which contributes to plasma leakage. One of the biomarkers of endothelial cell activation is soluble intercellular adhesion molecule 1 (sICAM-1).Method. An analytic observational study was conducted using BALB/c mice aged 8 weeks and weighed 40 grams. Selected BALB/c mice were randomly assigned to serotype 2 dengue virus containing 2.1 x 106 pfu/ml intraperitoneally, given only once. A total of 11 mice were injected with dengue virus serotype 2 and 11 mice were not injected with dengue virus. On the second day of virus injection, non structural (NS) 1 antigen dengue examination was carried out to prove that the BALB/c mice were indeed infected with dengue virus. In BALB/c mice that were proven to be infected with dengue virus, sICAM-1 levels were examined in serum after 7 days of infection. Mice that were not injected with dengue virus also examined sICAM-1Results. All of BALB/c mice injected with dengue virus were proven to be infected, as indicated by the detection of NS1 antigen in their serum. The mean serum level of NS1 antigen was 88.35 ng/ml (mean 95.34 ng/ml and standard deviation 21.94). The level of sICAM-1 in BALB/c mice infected with dengue virus (mean = 1.34) was significantly higher than mice that were not infected (mean =  0.79), with a p-value 0.045Conclusions. BALB/c mice were proven to be infected with dengue virus by detecting ns1 dengue virus antigen in the serum. The sICAM-1 levels in the group of BALB/c mice infected with dengue serotype 2 were significantly higher than the BALB/c mice that were not infected with dengue virus.
Correlation Between CD4 Level and The Severity of Pneumocystis Pneumonia in Patients with Human Immunodeficiency Virus at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, Bali Aries Hasan Basri; I Made Susila Utama
MEDICINUS Vol. 38 No. 12 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/3b8w1665

Abstract

Pneumocystis jirovecii is an opportunistic fungal pathogen that causes life-threatening cases of pneumocystis pneumonia (PCP) in immunodeficient patients. In patients with human immunodeficiency virus (HIV), the risk of developing PCP increases when the CD4 count <200 cells/μl. This study aimed to determine the correlation between the CD4 level and the degree of severity of pneumocystis pneumonia in HIV patients at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, Bali. A retrospective analysis was conducted on HIV patients diagnosed with PCP between 2020 to 2022 period. The researchsubjects were all PCP-PCR positive patients who were hospitalized at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar. The results of the study showed a total of 120 subjects, including 28 (23.3%) male subjects with severe PCP and 11 (9.2%)female subjects with severe PCP. The highest number of cases was found in the age range ages 20‒40 years, with 20 (16.6%) subjects having severe PCP. Regarding treatment status, 23 (19.2%) subjects with severe PCP were pre-HAART(highly active antiretroviral therapy) while 16 (13.3%) subjects were on HAART. The highest proportion of severe PCP cases was found in subjects with a CD4 count of less than 50 cells/μl, totaling 32 subjects (26.6%). The Kruskal-Wallistest was applied to assess the association between the CD4 count categories and PCP severity in HIV patients. The study concluded that there is a significant correlation between CD4 levels and the severity of pneumocystis pneumonia in HIVpatientsat RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar.
Karakteristik Pasien dan Tata Laksana Infeksi Malaria di RSUP Prof. dr. I.G.N.G. Ngoerah Denpasar Tahun 2019-2023 I Dewa Gede Agung Suta Ariwangsa; Harris Hardian; I Made Susila Utama
MEDICINUS Vol. 38 No. 12 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/1xmve570

Abstract

Introduction: Malaria remains a major public health concern, affecting resident and travellers to endemic areas. Severemalaria is a complication of infection that can lead to poor outcomes when late to be diagnosed. The use of artemisininRESEARCH22 VOL. 38 ISSUE 12, DECEMBER 2025derivatives or artemisinin-based combination therapy (ACT) has been reported to improve outcomes and survival in malaria patients. Methods: This was a descriptive study. Data were collected retrospectively from medical records ofpatients treated at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar from 2019 to 2023. Descriptive analyses were conducted to summarize patient's characteristics, infection etiology, malaria severity, and treatment outcomes. Results: A total of37 malaria cases were treated at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar between 2019 and 2023. The mean age of patients was 29.85 years, and the majority were male (78.37%). Plasmodium vivax was identified as the most commonetiologic agent, in 19 cases (51.35%), followed by Plasmodium falciparum in 17 cases (45.94%), and Plasmodium malariae in 1 case (2.7%). Severe malaria was diagnosed in 9 cases (24.32%), predominantly caused by P. falciparum (7 cases,94.5%). Jaundice and renal dysfunction were the most frequent clinical findings in severe malaria, seen in 7 (77.77%) and 4 (44.44%) cases, respectively. The most common treatment regimens were 3-day dihydroartemisinin-piperaquine (DHP) plus 14-day primaquine in 10 patients (48.64%), and 3-day DHP plus 1-day primaquine in another 10 patients (27.02%).Intravenous artesunate followed by 3-day DHP and 3-day primaquine was administered to 7 patients (18.91%); artesunate followed by DHP and 1-day primaquine to 1 patient (2.7%), and artesunate followed by DHP alone to 1 patient (2.7%). Nodeaths were reported during treatment. Discussion: Severe malaria was identified in 9 out of 37 cases (24.3%), with P. vivax being the most common malaria species overall. Although severe malaria is typically associated with P. falciparumand P. vivax, this study also reported one severe case caused by P. malariae. Jaundice was the most common clinical presentation, often accompanied by renal impairment. All patients received artemisinin-based combination therapy andachieved complete recovery at the end of treatment. Conclusion: Severe malaria occurred in one-quarter of malariacases, with P. falciparum being the most frequent cause. Jaundice and renal dysfunction were the most common clinical manifestations. All patients recovered and were discharged from the hospital.
Co-Authors A.A. Ayu Yuli Gayatri, A.A. Ayu Yuli Agung Bagus S. Satyarsa Agus Somia Agus Somia, Agus Somia Anak Agung Ayu Yuli Gayatri Aries Hasan Basri Cokorda Agung Wahyu Purnamasidhi Elmeizi Arafah Gde Adit Putra Deva Harris Hardian Haruko Akatsu I Dewa Gede Agung Suta Ariwangsa I Dewa Nyoman Wibawa I Ketut Agus Somia I Made Bakta Jessica Santosa Ketut Ridana Wibawa Ketut Tuti Parwati Merati Made Jawi Ni Made Dewi Dian Sukmawati Ni Made Renny A Rena Nur Rizky Amaliah Rinto . Tuti P Merati, Tuti P Tuti Parwati Tuti Parwati Merati Tuty Parwati M